CCRN Endocrine and Metabolic Crises 4

Question 1

A nurse correcting hyponatremia is careful to raise serum sodium slowly to avoid which serious complication?

Accepted Answer

Osmotic demyelination syndrome (central pontine myelinolysis)

Answer

Cerebral edema

Answer

Rhabdomyolysis

Answer

Acute tubular necrosis

Question 2

Central diabetes insipidus is most appropriately treated with which medication?

Accepted Answer

Desmopressin (DDAVP)

Answer

Furosemide

Answer

Hydrochlorothiazide alone

Answer

Mannitol

Question 3

A postoperative neurosurgical patient develops urine output of 800 mL/hr with rising serum sodium. What condition should the nurse suspect?

Accepted Answer

Diabetes insipidus

Answer

SIADH

Answer

Acute kidney injury

Answer

Cerebral salt wasting with hyponatremia

Question 4

Which finding indicates effective treatment of DKA?

Accepted Answer

Closure of the anion gap and resolution of ketosis

Answer

Glucose returning to exactly 100 mg/dL

Answer

Disappearance of urine output

Answer

Increase in serum ketones

Question 5

A patient in adrenal crisis is most likely to display which electrolyte pattern?

Accepted Answer

Hyponatremia and hyperkalemia

Answer

Hypernatremia and hypokalemia

Answer

Hypernatremia and hyperkalemia

Answer

Hyponatremia and hypokalemia

Question 6

Which precipitating factor most commonly triggers adrenal crisis in a patient on chronic corticosteroids?

Accepted Answer

Abrupt withdrawal of steroids or acute stress without dose increase

Answer

Excessive steroid dosing

Answer

High dietary sodium intake

Answer

Routine ambulation

Question 7

A beta-blocker such as propranolol is used in thyroid storm primarily to address which problem?

Accepted Answer

Tachycardia and adrenergic symptoms

Answer

Hypothermia

Answer

Hypoglycemia

Answer

Hyponatremia